Medical Knowledge
- To describe basic examination techniques for strabismus (e.g., ductions and versions, cover and uncover testing, alternate cover testing, prism cover testing).
- To describe basic visual development and visual assessment of the pediatric ophthalmology patient (e.g., central, steady, maintained fixation; illiterate E, Allen cards, Landolt C rings).
- To describe basic anatomy and physiology of strabismus (e.g., innervation of extraocular muscles,primary actions, comitant and incomitant deviations, overaction and underaction, restrictive and paretic, saccades and pursuit movements).
- To describe basic sensory adaptations for binocular vision (e.g., normal and anomalous retinal correspondence, suppression, horopter, Panum’s area, fusion, stereopsis).
- To describe and recognize pseudostrabismus.
- To describe basics of binocular sensory testing (e.g., Titmus stereo testing, Randot stereo testing, Worth 4-dot, Bagolini lenses, afterimage testing).
- To describe different etiologies of amblyopia (e.g., deprivation, ametropic, strabismic,anisometropic, organic).
- To describe etiologies of esotropia (e.g., congenital, comitant and incomitant, accommodative and non-accommodative, decompensated, sensory, neurogenic, myogenic, neuromuscular junction, restrictive, nystagmus blockage syndrome, spasm of the near, monofixation syndrome, consecutive).
- To describe etiologies of exotropia (e.g., congenital, comitant and incomitant, decompensated, sensory, neurogenic, myogenic, neuromuscular junction, restrictive, basic, divergence excess, exophoria, convergence insufficiency).
- To describe various strabismus patterns (e.g., A or V pattern).
- To describe etiologies, evaluation, and management of vertical strabismus (e.g., neurogenic, myogenic, neuromuscular junction, oblique overaction, dissociated vertical deviation, restrictive).
- To describe non-surgical treatment of strabismus.
- To describe different forms of childhood nystagmus.
- To describe features, classification, and treatment indications for retinopathy of prematurity.
- To describe etiologies and types of pediatric cataracts.
- To describe and recognize ocular findings in child abuse (e.g., retinal hemorrhages) and appropriately refer to child protective services or other authorities.
- To describe common hereditary or congenital ocular motility or lid syndromes (e.g., Duane syndrome, Marcus Gunn jaw winking, Brown syndrome).
- To describe typical features of retinoblastoma.
- To describe basic features of dyslexia.
- To describe basic evaluation of decreased vision in infants and children (e.g., retinopathy of prematurity, hereditary retinal disorders, congenital glaucoma, measles, vitamin A deficiency).
- To describe identifiable congenital ocular anomalies (e.g., microphthalmia, persistent fetal vasculature).
- To describe ocular findings in inherited, metabolic disorders
- Mucopolysaccharidoses (e.g., Hurler syndrome, Scheie syndrome, Hunter syndrome, San Fillipo syndrome, Morquio syndrome, Sly syndrome).
- Lipidoses (e.g., Tay-Sachs disease, Sandhoff, Niemann-Pick, Krabbe’s, Gaucher’s, Fabry’s, metachromatic leukodystrophy).
- Aminoacidurias (e.g., homocystinuria, cystinosis, Lowe, Zellweger).
- To describe ocular findings in chromosomal abnormalities (e.g., Trisomy 21, Trisomy 13, Trisomy 18, Short arm 11 deletion, Long arm 13 deletion, Cri du Chat, Turner).
- To describe recognizable causes of blindness in infants (e.g., albinism, optic nerve hypoplasia, achromatopsia, Leber’s congenital amaurosis, retinal dystrophy, congenital optic atrophy).
- To describe etiology, evaluation, and management of congenital infections (e.g., toxoplasmosis, rubella, cytomegalovirus, syphilis, herpes).
- To describe and recognize the common causes of pediatric uveitis.
Patient Care
- To perform an extraocular muscle examination based on knowledge of the anatomy and physiology of ocular motility.
- To assess ocular motility using ductions and versions testing.
- To perform basic measurement of strabismus (e.g., Hirschberg, Krimsky, cover testing, prism cover testing, simultaneous prism cover test, alternate cover testing, Parks-Bielschowsky three-step test, Maddox rod testing, double Maddox rod testing).
- To perform assessment of vision in the neonate, infant, and child.
- To recognize and apply in a clinical setting the following skills in the ocular motility examination (simple, advanced)
- Stereoacuity testing
- Accommodative convergence/accommodation ratio (e.g., heterophoria method, gradient method)
- Tests of binocularity and retinal correspondence
- Cycloplegic refraction (retinoscopy)
- Anterior and posterior segment examination
- Basic and advanced measurement of strabismus
- Cover test measurement
- Assessment of vision
- Teller acuity cards
- Fixation preference test
- Standard subjective visual acuity tests
- Induced tropia test
- To perform extraocular muscle surgery including:
- Recession
- Resection
- To assist a primary surgeon performing
- Muscle weakening (e.g., tenotomy) and strengthening (e.g., tuck) procedures
- Transposition
- Use of adjustable sutures