How to Publish Your First Case Report as an Ophthalmology Resident

The first useful question is not “Which journal will take this?” It is “What can another clinician learn from this case that is specific, documented and honestly bounded?” A rare diagnosis is not automatically a reportable lesson, and a dramatic image is not a substitute for chronology, differential reasoning and permission.

This guide is for ophthalmology residents preparing a scholarly case report. It is not legal, ethics, privacy, employment or publication advice. Local institutional policies, the responsible consultant, the patient-consent process and the target journal’s current instructions control the work. No checklist can guarantee acceptance or publication.

Decide whether there is a report before you write one

Start with a one-sentence learning message. It should identify the clinical feature and the teaching consequence without making a novelty claim you cannot prove.

A case can be educational because it demonstrates an atypical presentation, an imaging correlation, a diagnostic pitfall, an unexpected complication, a differential distinction or a systems/process lesson. It does not need to prove superiority or create a new standard of care. In ophthalmology, the temptation is to let OCT, fundus, slit-lamp or operative images carry the story; make sure the text explains what the image adds and what it cannot establish.

Before you open a manuscript template, review the idea with the responsible senior clinician. Ask whether the learning point is accurate, whether the record is complete enough to support it, and whether another format — audit, image quiz, letter, conference abstract, teaching file or no publication — is more appropriate.

Put permissions and data handling before prose

Do not draft deeply on the assumption that permission will be easy later. First identify the current institutional route for case-report consent, ethics review/waiver assessment where applicable, image use, de-identification, data access, data storage and senior approval. Target journals may have their own declaration or consent wording. If the institutional and journal requirements differ, ask the responsible local authority how to proceed; do not improvise a hybrid form.

Use a minimal working file. Keep a secure, permitted source record separate from the manuscript workspace. In the manuscript, include only details necessary for the learning message. Direct identifiers are not the only risk: unusual chronology, dates, occupation, location, images, scan labels and combinations of facts can make a person recognisable. Cropping an image is not a universal de-identification test.

Do not put patient identifiers into notes shared casually over messaging apps, personal email or unsecured cloud folders. If you are unsure whether an image or detail may be used, stop and ask the supervisor or the institutional privacy/ethics route. That is not bureaucracy after the interesting work; it is part of making the report defensible.

Build the evidence timeline

The case section should let a reader see the order of events. Create the timeline before writing paragraphs. Record presentation, relevant background, examination, investigations, working differential, decision points, intervention or observation, follow-up and outcome/limits. Do not make the timeline cleaner than the record: uncertainty, incomplete follow-up and alternative explanations belong in the manuscript where they are material.

For each proposed sentence, ask “What record supports this?” A useful internal tag is one of: history, examination, imaging, laboratory, operative record, follow-up, literature interpretation, or author inference. The final manuscript will not show these tags, but they expose when an elegant sentence is actually an unsupported inference.

Be especially careful with causal language. “After” does not establish “because of.” A temporal association, an observed response and a plausible mechanism are different levels of claim. Describe what was observed, cite what the literature supports, and make limits explicit.

Agree authorship and roles early

Authorship should be discussed before the last night before submission. The ICMJE Recommendations are a useful gateway for current authorship and publication principles; they are not a substitute for your institution’s policy or a way to settle a local disagreement.¹

At a minimum, record who contributed to the clinical work, concept, literature search, drafting, critical revision, image preparation and final factual review. Author order and corresponding-author responsibility should be agreed transparently. Do not add someone solely because of seniority, and do not omit a person who meets the applicable contribution/authorship standard. If the department has an authorship-dispute process, use it early rather than trying to repair a conflict after the draft is circulating.

The resident’s role is often substantial: organising the timeline, conducting a documented search, drafting, revising and coordinating source checks. That work is valuable only when the clinical facts are also verified by appropriate supervisors and every listed author accepts the responsibility required by the journal.

Search for context, not a headline that proves novelty

Search before writing “first,” “only,” “never,” “novel,” “pathognomonic” or “caused by.” Begin with the diagnosis plus the discriminating feature, then search the differential, imaging modality, complication or procedure. Record database, date, search string and the most relevant comparable reports. A quick search may justify cautious wording such as “few reports were identified in this limited search”; it usually does not justify a universal claim.

When you read a comparator, extract four fields: patient/context, finding/course, intervention/observation and what is actually comparable. A paper with the same diagnosis but a different age group, imaging pattern, genetic context, procedure or follow-up may be useful background rather than proof of sameness. This is how the discussion becomes analytical rather than a pile of citations.

Draft with CARE as a completeness tool

The CARE Statement and its checklist provide a reporting framework for case reports, and the CARE guideline elaboration explains why transparent case information, patient perspective where appropriate, consent and chronology matter.²³ Use the framework to find omissions; do not turn it into a claim that your report is ethically approved, complete in every setting or publishable.

Write the discussion last. Its job is to explain what this one patient can and cannot add to the existing literature. State relevant limitations plainly: incomplete follow-up, unavailable investigation, a competing explanation, referral bias or a feature that cannot be generalised. A limitation is not an apology; it tells the reader where the learning boundary lies.

Choose a journal only after the manuscript has a shape

Make a shortlist using official journal author instructions, not only indexing claims or social-media recommendations. Confirm that the journal currently accepts case reports in your clinical area and read its article category, word count, abstract format, image limit, reference style, consent/declaration wording, figure requirements, fees where applicable, submission system and editorial policies. Save the instructions page with the date checked because categories and policies change.

Never assume that a journal will accept a case because it publishes similar material. Match improves relevance; it does not create an outcome. Avoid predatory-journal assumptions by checking the journal’s own publisher and policy information with your department/library before submitting or paying anything. If an invitation arrives by email, treat it as an invitation to verify, not a reason to rush.

The 30-minute pre-submission audit

Before the corresponding author submits, run this checklist together:

1. Does every author approve the final version and meet the current journal/institution standard?
2. Does the consent/permission status match the journal’s required declaration and the institution’s process?
3. Are images necessary, permitted, de-identified to the required standard and captioned accurately?
4. Does the timeline match the source record, including uncertainty and follow-up?
5. Has every “first,” “novel,” causal or superiority phrase been removed or sourced and qualified?
6. Does each reference support the sentence before it?
7. Does the manuscript match the journal’s current category, word count and file instructions?
8. Are conflicts, funding, contributors and acknowledgements described as required?

If the answer to a required item is “we think so,” it is not ready. Find the document, ask the responsible person or remove the claim. A rejection or revision request is an editorial decision, not evidence that the case had no educational value; respond professionally, preserve the record and revise only after checking the journal’s instructions.

Keep a version log during this stage. Record who changed clinical wording, why a figure was replaced or removed, and which author confirmed a revised interpretation. That small habit prevents contradictory versions from circulating and makes final approval more meaningful.

Build academic habits alongside clinical training

A case report is one way to practise a transferable sequence: precise observation, chronology, source discipline, honest uncertainty and concise communication. The free resources hub is a route to general learning resources. A case presentation format may help you structure a clinical chronology before you turn it into manuscript prose; check its current sample and product information rather than assuming a publication function. The fellowship preparation page and ophthalmology glossary are further verified study routes, not publication or career-placement services.

Sources and scope

The CARE framework and ICMJE recommendations are reporting/publication-principle sources. They do not replace local ethics, consent, privacy, hospital, data-governance, journal or legal requirements. Re-open all target-journal instructions immediately before submission.

Footnotes

1. International Committee of Medical Journal Editors. Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals. Live-checked 18 August 2026. ↩

2. CARE Case Report Guidelines. CARE Statement. Live-checked 18 August 2026. ↩

3. Gagnier JJ, Kienle G, Altman DG, et al. The CARE guidelines: consensus-based clinical case reporting guideline development. Journal of Clinical Epidemiology. 2014. Live-checked 18 August 2026. ↩