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Binocular vision case studies

Sosena Tang describes another binocular vision presentation and asks for your clinical opinion

Presentation

A 14-year-old girl complains of difficulty with near work for the past six months. This has been worse during revision time. She noticed that words blur or can run together and she also experiences sore eyes at the end of the school day. Re-focusing to distance vision can also be a problem after reading for a period of time.

General health: Normal
POH: None
Family history: None

Visions:

Dist: R 6/6 L 6/6 Bin 6/6 (Snellen letters on a line)
Near: R N4.5 L N4.5 Bin N4.5

Cover test:

Dist: Orthophoria
Near: 20? esophoria breaks to alternating esotropia (moderate recovery)

Retinoscopy:

R +0.50DS 6/6 N4.5
L +0.50DS 6/6 N4.5

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