Pediatric and Geriatric Optometry
Core concepts
In pediatrics, know the milestones of visual development, amblyopia types (strabismic, refractive, deprivation), and the importance of early screening. Understand retinoscopy in children, cycloplegic refraction, and the management of accommodative esotropia. In geriatrics, recognize age-related changes: presbyopia, cataract, dry eye, and age-related macular degeneration. Understand polypharmacy and its ocular effects, and the value of low vision rehabilitation.
Traps
Questions often test the critical period for amblyopia treatment: earlier intervention yields better outcomes. Do not confuse pseudostrabismus (epicanthal folds) with true strabismus. In older adults, a sudden onset of floaters and flashes is not benign aging; it requires urgent evaluation for retinal tear.
Worked rule of thumb
For a child with accommodative esotropia, prescribe the full cycloplegic hyperopic correction and reassess; if the deviation persists, consider bifocals or surgery. For an older adult with new metamorphopsia, use an Amsler grid and refer for retinal evaluation.