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Case 2 Presentation
A five-year-old boy attends for his first eye examination, as his mother is concerned about his eyes. He does not concentrate well at school although is verbally articulate. His reading progress is also slower than expected. For the past year, his RE appeared to turn in intermittently when he was tired and has seemed worse in the last month since he had a bad chest infection.
General health: Normal. Full-term pregnancy with a normal birth history and delivery.
POH:
None
Family history: Both father and grandmother wear 'thick' glasses. Grandmother may have had a 'weaker eye'.
Visions:
Dist: R 6/9 L 6/9 Bin 6/9 (Snellen letters on a line)
Near: R N8 L N8 Bin N8
Cover test:
Dist: R 20? esotropia > alternating esotropia (moderate recovery)
Near: R 20? esotropia > alternating esotropia (moderate recovery)
Retinoscopy: (Reflex fluctuating)
R +4.50DS/-0.50DCx 170 VA 6/9
L +4.00DS VA 6/9
Cover test: (with retinoscopy result)
Dist: 10? Esophoria
Near: 10? Esophoria
Motility: normal
Stereopis (without Rx): Not demonstrated (TNO)
Near point of convergence: To nose
ophthalmoscopy: Normal