Introduction: This study evaluates the extent of patient care and revenue losses within Pediatric Ophthalmology (PO) practices as they rebound from the COVID-19 pandemic shutdown. Methods: Two surveys of active AAPOS members were performed in 2020 at the pandemic peak “lockdown” phase 1 and again in the early recovery phase comparing practice data to the prior year. The authors extrapolated from AAO/ AAPOS 2018 Academetrics to identify specific clinical and financial outcomes. Results: Median surgical volume in April was 26% of normal, improving to 66% by mid-July, consequently, 76,892 surgeries were not performed. As of July, clinic examinations decreased by 27%, accounting for 461 lost examinations perprovider or 484,065 examinations not performed. Medicaid patients were disproportionately affected with 242,033 clinic examinations not performed. Clinical revenue decreased 77% in April and 55% in July. University/hospital and private practice/employed POs whose salary was consistent with the prior year were 69% and 9% respectively in July. As of July, the average doctor lost $85,358 in salary revenue translating into cumulative loss of $233,606,100 for PO physicians. Assuming PO practices continue functioning at current levels, 73% of capacity, through next April, over 1,480,670 examinations and 113,360 surgeries will not have occurred over a 1-year period since the initial survey. Conclusion/Relevance: While there has been healthy economic rebound for many, this historic event continues to jeopardize access to care for patients and threaten the economic viability of many PO practices. Societal and financial costs of morbidity due to past and future missed/delayed examinations cannot be measured at this time.