Paediatric Ophthalmology
Core concepts
Understand visual development and the critical period for amblyopia. Know screening for retinopathy of prematurity and red reflex testing. Recognise congenital cataract, congenital glaucoma, and retinoblastoma. Learn the approach to leukocoria and strabismus in children. Understand refractive error development and when to prescribe glasses. Know the principles of patching and atropine penalisation.
Traps
Examiners test that leukocoria has a differential including retinoblastoma, congenital cataract, and ROP. Remember congenital glaucoma presents with tearing, photophobia, and corneal enlargement. Do not miss retinoblastoma in a child with a white pupillary reflex. Amblyopia treatment is time-sensitive.
Worked example
A newborn has a white pupillary reflex. Perform a red reflex examination and refer urgently; retinoblastoma must be excluded. Rule of thumb: any absent red reflex requires urgent evaluation.