Course: The Young Eye: Embryology, Part 2 - Second trimester to birth

Section

General

Domains: Clinical practice, Communication

No CPD Points

The human eye is one of the most complex organs in the body. Its formation during early development defines its functions and qualities for the rest of our lives.

In this two-part series, we follow the developmental journey of one foetus from conception through to birth. Starting at the very beginning we examine the issues that can arise at each developmental stage and the clinical conditions they result in.

Before you start the second part of the course, please ensure that you have either completed The Young Eye: Embryology - Part One or you are familiar with the content.

Part two follows foetal development through the remainder of pregnancy, looking further at the formation of ocular structures such as the retina, the anterior eye and the extra-ocular muscles. It also explores how maternal behaviour, such as alcohol or drug consumption can affect the foetus’ development at this stage. Additionally, the importance of nutrition is reviewed, along with the consequences of dietary deficiencies.

By the final trimester, all the components of the foetus’s eye are recognisable, though their cells will continue to mature even after birth. Unit five looks at these processes that make up final ocular development. It will also outline the defects that can be caused by a premature or traumatic birth, and what tests can be used to determine the abilities of the eyes following parturition.

The aim of the course is to raise awareness of risks to pregnant women regarding eye disease and offer a better understanding why some people express various conditions, so you can explain those to your patients.

Last published: December 2022

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Learning outcomes

Communication

s.2 Communicate effectively with patients

Knowledge of the nature of ocular disease development during pregnancy and so be better able to explain the relevance of and risks for a range of common ocular conditions and offer advice to pregnant patients.

Clinical Practice

s.5 Keep your knowledge and skills up to date

Understand the influences upon the mother and foetus in the second and third trimesters of gestation, during birth and the first few months post-partum and how they may influence eye development and the presentation of a range of ocular disorders.

s.7 Conduct appropriate assessments, examinations, treatments and referrals

Understand the aetiology of congenital abnormalities of binocular vision and so be better able to investigate and advise upon them.

Unit 4 - Second trimester (~14 mins)

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You can work through each section of this course at your own pace and return to any section as many times as you like. When you have finished the training go to the Evaluation section.

You may find it easier to view this course on a desktop computer or a tablet due to the detailed content. See our FAQ on how to screencast from a phone to a larger screen.

Click below to launch the course.

e-LearningUnit 4 - Second trimester e-Learning
Additional reading
Wright K, Spiegel, P (2003) Pediatric Ophthalmology and Strabismus. Springer.
References
Fernandes M et al. (2014) Smoking during pregnancy and vision difficulties in children: a systematic review. Acta Ophthalmologica 93(3), 213-223

Ghiasvand N et al. (2011) Deletion of a remote enhancer near ATOH7 disrupts retinal neurogenesis, causing NCRNA disease. Nature Neuroscience 14(5), 578-586
URLGyllencreutz E, Aring E, Landgren V et al. (2020) Ophthalmologic Findings in Fetal Alcohol Spectrum Disorders - A Cohort Study From Childhood to Adulthood. American journal of ophthalmology; 214, pp 14–20 [Accessed Dec 2021] URL Opens in a new window.
Peragallo J, Biousse V, Newman N (2013) Ocular manifestations of drug and alcohol abuse. Current Opinion in Ophthalmology 24(6), 566-573

Strömland K (2004) Visual impairment and ocular abnormalities in children with fetal alcohol syndrome. Addiction Biology 9(2), 153-157
Teixeira L et al (2014) Ultrastructural Abnormalities of the Trabecular Meshwork Extracellular Matrix in Cyp1b1-Deficient Mice. Veterinary Pathology 52(2), 397-403

Unit 5 - From birth onwards (~20 min)

Please note: You will need to allow 'pop ups' on your browser in order to view this content.

You can work through each section of this course at your own pace and return to any section as many times as you like. When you have finished the training go to the Evaluation section.

You may find it easier to view this course on a desktop computer or a tablet due to the detailed content. See our FAQ on how to screencast from a phone to a larger screen.

Click below to launch the course.

e-LearningUnit 5 - From birth onwards e-Learning
Additional reading
Wright K, Spiegel, P (2003) Pediatric Ophthalmology and Strabismus. Springer.
References
Brown A (1990) Development of visual sensitivity to light and color vision in human infants: A critical review. Vision Research 30(8), 1159-1188
Chen J, Smith L (2007) Retinopathy of prematurity. Angiogenesis 10(2), 133-140
Cleary-Goldman J et al (2005) Impact of maternal age on obstetric outcome. Obstetrics and Gynecology 105(5 Pt 1), 983-990
Eventov-Friedman S et al (2010) The red reflex examination in neonates: An efficient tool for early diagnosis of congenital ocular diseases. Israel Medical Association Journal 12(5), 259-261
URLKim S, Port A, Swan R et al. (2018) Retinopathy of prematurity: a review of risk factors and their clinical significance. Survey of ophthalmology; 63(5), pp 618–637 [Accessed Dec 2021] URL Opens in a new window.
Mills D (1999) The Eye in Childhood. American Family Physician 1;60(3), 907-916
Seemiller E, Wang J, Candy T (2016) Sensitivity of vergence responses of 5 to 10-week-old human infants. Journal of Vision 16(3), 20
URLToli A, Perente A, Labiris G (2021) Evaluation of the red reflex: An overview for the pediatrician. World journal of methodology; 11(5), pp 263–277 [Accessed Dec 2021] URL Opens in a new window.
Varghese R et al (2009) Refractive status at birth: Its relation to newborn physical parameters at birth and gestational age. PLOS ONE 4(2), p.e4469
Zhu X, Zhao R, Wang Y et al. (2017) Refractive state and optical compositions of preterm children with and without retinopathy of prematurity in the first 6 years of life. Medicine; 96 (45), p e8565

More information

Docet would like to thank the following for their contribution to this programme:
SME advisors:
Dr Patrick Calvas, Department of Medical Genetics, Toulouse University Hospital Centre
Dr Nicolas Chassaing, Department of Medical Genetics, Toulouse University Hospital Centre
Dr Sophie Creuzet, Alfred Fessard Institute of Neurobiology
Whitney Heavner, Interdisciplinary Scholar, Stanford Neurosciences Institute
Saurabh Jain FRCOphth, Consultant Ophthalmologist and Clinical Director Royal Free London NHS Foundation Trust
Ian Simmons, Consultant Paediatric Ophthalmologist and Ophthalmic Surgeon, Leeds Teaching Hospital NHS Trust

Voiceover by Katie Reddin-Clancy.

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