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 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
Professionalism
To treat patients with respect and compassion at all times
To treat clinical and administrative staff with respect
To treat medical students with respect and strive to create an atmosphere conducive to education
To arrive on-time for clinical experiences
To prepare in advance for surgical experiences
To work to become part of the clinical team
To work with the faculty, staff, fellow and other residents on the service to determine your responsibilities
To remain flexible and offer to help out with the responsibilities of others when you can
To remain visible and available to participate in clinical care throughout the clinical session. If you leave the clinical care area make sure that other members of the service know where you are and why
answer your pager within 10 minutes of being paged.
Interpersonal and communication skills
To communicate your name and role on the service to patients and their families.
"Hello, I'm Dr. Resident, I'm a resident working with Dr. Attending today."
To present patients to the attending in a succinct but complete way
To maintain timely and legible medical records
To talk when you should be talking, listen when you should be listening
Practice-based learning and improvement
To learn to recognize feedback from faculty, fellows, fellow residents, patients and students
To accept that feedback constructively and work to improve based on it
To accept your role as a teacher as well as a learner. Work to educate students, fellow residents, faculty, staff and patients
Systems based practice
To work for the benefit of your patients to communicate with other health care provider
To act as an advocate for your patient within the health care system
To become aware of the costs of diagnostic and therapeutic interventions. Consider these costs as you recommend and prescribe these interventions.
