PEDIATRICS IN PRIMARY CARE: (PEDIATRIC
OPHTHALMOLOGY FOR THE PCP: PART 1 BASICS,
SCREENING, STRABISMUS, AND AMBLYOPIA)LATEST
UPDATE 2025
1. The eye is full size at birth (true or false) ANS >> false
2. What size is the eye at birth (40 weeks gestational age) 1. Axial length
peds vs adult 2. Anterior segment size 3. Posterior segment size 4. Scleral
thickness ANS >> 1. PEDS 16-18 mm vs ADULT 23 mm
2. Anterior segment (~75% the adult size)
3. Posterior segment (~50% the adult size)
4. Scleral thickness is (~50% the adult size)
3. Eye Growth (1st phase, 2nd phase, 3rd phase) ANS >> 1st phase (rapid
growth in the 1st 18 months of life; increases to ~20 mm axial length)
2nd phase (from 2-5 y.o.; increases to ~21-22 mm axial length)
3rd phase (from 5-13 y.o.; increases to adult size)
4. Eye Growth and Prematurity Concerns ANS >> 1. Retinopathy of Prematurity
2. Corneal clarity
3. Lens clarity
5. Refractive error progression ANS >> Hyperopia (Far-sighted) to Myopia (Near-
sighted)
6. Normal Vision Development Requirements ANS >> 1. EYE REQUIREMENTS
ANS >>
,-Clear retinal images
-Equal image clarity b/w the 2 eyes
-Proper eye alignment
2. TRANSMISSION OF VISUAL STIMULUS TO BRAIN
-Normal optic nerves
3. NORMAL OCCIPITAL AND CORTICAL RESPONSE
7. Visual Development Milestones (0-2 Months) ANS >> 1. Pupillary light reaction
2. Sporadic fixation, early following
3. Jerky saccadic eye movements
4. Misalignments common- especially extropia
8. Visual Development Milestones (2-6 Months) ANS >> 1. Central fixation
and follow improving (especially familiar objections, i.e. mother's face)
2. Binocular smooth persuits
3. By 6 months should be straight without deviation
9. Visual Development Milestones (6 months-2 years) ANS >> 1. Central,
steady, main- tained vision
2. Coordinated reaching for objects
3. Accurate and smooth pursuits and saccadic movements
4. Orthophoria
10. Visual Development Milestones (3-5 years) ANS >> 1. At least 20/40
(tested on Snellen equivalent chart) in EACH eye
, 2. No difference of greater than 2 lines b/w the eyes
OPHTHALMOLOGY FOR THE PCP: PART 1 BASICS,
SCREENING, STRABISMUS, AND AMBLYOPIA)LATEST
UPDATE 2025
1. The eye is full size at birth (true or false) ANS >> false
2. What size is the eye at birth (40 weeks gestational age) 1. Axial length
peds vs adult 2. Anterior segment size 3. Posterior segment size 4. Scleral
thickness ANS >> 1. PEDS 16-18 mm vs ADULT 23 mm
2. Anterior segment (~75% the adult size)
3. Posterior segment (~50% the adult size)
4. Scleral thickness is (~50% the adult size)
3. Eye Growth (1st phase, 2nd phase, 3rd phase) ANS >> 1st phase (rapid
growth in the 1st 18 months of life; increases to ~20 mm axial length)
2nd phase (from 2-5 y.o.; increases to ~21-22 mm axial length)
3rd phase (from 5-13 y.o.; increases to adult size)
4. Eye Growth and Prematurity Concerns ANS >> 1. Retinopathy of Prematurity
2. Corneal clarity
3. Lens clarity
5. Refractive error progression ANS >> Hyperopia (Far-sighted) to Myopia (Near-
sighted)
6. Normal Vision Development Requirements ANS >> 1. EYE REQUIREMENTS
ANS >>
,-Clear retinal images
-Equal image clarity b/w the 2 eyes
-Proper eye alignment
2. TRANSMISSION OF VISUAL STIMULUS TO BRAIN
-Normal optic nerves
3. NORMAL OCCIPITAL AND CORTICAL RESPONSE
7. Visual Development Milestones (0-2 Months) ANS >> 1. Pupillary light reaction
2. Sporadic fixation, early following
3. Jerky saccadic eye movements
4. Misalignments common- especially extropia
8. Visual Development Milestones (2-6 Months) ANS >> 1. Central fixation
and follow improving (especially familiar objections, i.e. mother's face)
2. Binocular smooth persuits
3. By 6 months should be straight without deviation
9. Visual Development Milestones (6 months-2 years) ANS >> 1. Central,
steady, main- tained vision
2. Coordinated reaching for objects
3. Accurate and smooth pursuits and saccadic movements
4. Orthophoria
10. Visual Development Milestones (3-5 years) ANS >> 1. At least 20/40
(tested on Snellen equivalent chart) in EACH eye
, 2. No difference of greater than 2 lines b/w the eyes
