The macula is poorly developed at birth but changes rapidly during the first 4 years of life. Most significant are changes in macular pigmentation, development of the annular ring and foveal light reflex, and differentiation of cone photoreceptors. Improvement in visual acuity with age is due in part to development of the macula, specifically, differentiation of cone photoreceptors, narrowing of the rod-free zone, and an increase in foveal cone density (see Chapter 5). Retinal vascularization begins at the optic disc at 16 weeks’ gestational age and proceeds to the peripheral retina, reaching the temporal ora serrata by 40 weeks’ gestational age.
Hendrickson A, Possin D, Lejla V, Toth CA. Histologic development of the human fovea from midgestation to maturity. Am J Ophthalmol. 2012;154(5):767–778.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.