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How to Master Pediatric Ophthalmology and Strabismus with the BCSC Section 06



How to Master Pediatric Ophthalmology and Strabismus with the BCSC Section 06




Pediatric ophthalmology and strabismus are two of the most challenging and rewarding subspecialties in ophthalmology. They require a thorough understanding of the anatomy, physiology, pathology, and treatment of the developing visual system and the various ocular misalignment disorders.


If you are looking for a comprehensive and up-to-date resource to help you prepare for the board exams or update your clinical knowledge, you should consider the 2016-2017 Basic and Clinical Science Course (BCSC), Section 06: Pediatric Ophthalmology and Strabismus.


2016-2017 Basic And Clinical Science Course (BCSC), Section 06: Pediatric Ophthalmology And Strabism



The BCSC is a series of 13 volumes that cover all the major topics in ophthalmology. It is published by the American Academy of Ophthalmology (AAO) and written by leading experts in the field. The BCSC is revised every year to reflect the latest advances and best practices in ophthalmic medicine.


The Section 06 covers the following topics:


  • The development and maturation of vision in infants and children



  • The evaluation and management of amblyopia, refractive errors, and ocular motility disorders in children



  • The diagnosis and treatment of common pediatric eye diseases such as congenital cataract, glaucoma, retinopathy of prematurity, retinoblastoma, and uveitis



  • The principles and techniques of pediatric ophthalmic surgery, including strabismus surgery, cataract surgery, glaucoma surgery, and ocular oncology surgery



  • The special considerations and complications of pediatric ophthalmology and strabismus in relation to systemic diseases, trauma, genetics, syndromes, and neuro-ophthalmology



The Section 06 also includes numerous tables, figures, photographs, videos, and clinical pearls to illustrate and enhance the learning experience. It also provides self-assessment questions and answers at the end of each chapter to help you test your knowledge and identify areas for improvement.


Whether you are a resident, fellow, or practicing ophthalmologist, the BCSC Section 06 is an invaluable tool to help you master pediatric ophthalmology and strabismus. You can order it online from the AAO store or access it electronically through the AAO website or app.


In this article, we will review some of the key points and highlights from the BCSC Section 06. We will also provide some tips and resources to help you study more effectively and efficiently.


Development and Maturation of Vision




One of the most important aspects of pediatric ophthalmology is understanding how vision develops and matures in infants and children. This is essential for detecting and treating any abnormalities or delays that may affect the visual outcome and quality of life.


The BCSC Section 06 provides a detailed overview of the embryology, anatomy, physiology, and neurology of the visual system. It also explains how to perform a comprehensive eye examination in children of different ages and developmental stages. It covers the methods and instruments for assessing visual acuity, refractive status, ocular alignment, binocular vision, color vision, contrast sensitivity, visual fields, and ocular health.


Some of the key points to remember are:


  • Vision is a complex process that involves the interaction of the eye, the brain, and the environment.



  • The visual system begins to develop in the third week of gestation and continues to mature until late childhood or early adolescence.



  • The critical period for visual development is the first few years of life, when the brain is most sensitive and responsive to visual stimuli. Any disruption or deprivation of normal visual input during this period can result in amblyopia or other visual impairments.



  • The most common causes of visual impairment in children are refractive errors, amblyopia, strabismus, cataract, glaucoma, retinal disorders, optic nerve disorders, and cortical visual impairment.



  • The goals of pediatric eye care are to prevent or treat any conditions that may interfere with normal visual development, to optimize visual function and binocularity, and to promote ocular health and safety.



Amblyopia, Refractive Errors, and Ocular Motility Disorders




Amblyopia, refractive errors, and ocular motility disorders are some of the most common and important conditions that affect children's vision. They can have a significant impact on their academic performance, social skills, self-esteem, and future career opportunities.


The BCSC Section 06 provides a comprehensive and evidence-based approach to the evaluation and management of these conditions. It covers the definition, classification, epidemiology, pathophysiology, diagnosis, differential diagnosis, treatment options, prognosis, and complications of each condition. It also discusses the current controversies and challenges in this field.


Some of the key points to remember are:


  • Amblyopia is a reduction in best-corrected visual acuity caused by abnormal visual experience during the critical period of development. It can be classified into three types: strabismic amblyopia (due to ocular misalignment), anisometropic amblyopia (due to unequal refractive errors), and deprivation amblyopia (due to occlusion or opacity of the visual axis).



  • The treatment of amblyopia consists of correcting the underlying cause (e.g., glasses for refractive errors, surgery for cataract) and inducing active use of the amblyopic eye (e.g., patching or atropine penalization of the fellow eye). The optimal duration and intensity of treatment depend on several factors such as age, severity, type, compliance, and response.



  • Refractive errors are deviations from emmetropia (normal vision) that result in blurred vision. They can be classified into four types: myopia (nearsightedness), hyperopia (farsightedness), astigmatism (irregular curvature), and presbyopia (age-related loss of accommodation). They can be corrected by glasses, contact lenses, or refractive surgery.



  • The prevalence and progression of refractive errors vary depending on genetic and environmental factors. Some refractive errors (e.g., high myopia) can increase the risk of ocular complications such as retinal detachment or glaucoma. Some refractive errors (e.g., anisometropia) can also cause amblyopia if not detected and treated early.



  • Ocular motility disorders are abnormalities in the alignment or movement of the eyes. They can be classified into two types: strabismus (ocular misalignment) and nystagmus (involuntary eye oscillations). They can be caused by various factors such as congenital defects, neurological disorders, trauma, inflammation, infection, or tumors.



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