History taking:
- c/o blurred vision at distance esp. in class while copying the letters from the whiteboard.
- No complaint of blurred vision at near.
- Occasional headache usually if she has fever.
- No AHP reported by her mother.
Test | RE | LE | BE |
Vision Testing D (using Snellen Chart) N | 6/9, Ph:NI N5@25cm | 6/9, Ph:6/6- N5@25cm | |
Retinoscopy | +0.50DS/-0.25DCX180 (6/6) | +0.50DS/-0.25DCX175 (6/6-1) | |
Accommodation assessment: AA (Expected:16.5±2D) Without RX With RX MEM Accom. Facility | 5,5,5 11,13,15 -0.50D 14cycle/min | 5,5,5 15,15,15 -0.50D 14cycle/min | 15,16,14 11,16,15 |
Cover Test | D: small XP with fast recovery N: small XP with fast recovery | ||
1) What is the DIAGNOSIS? Justify your answer?
2) How to manage this case?
Iprepared by group 2..
Iprepared by group 2..
salam
ReplyDelete1. accommodation spasm based on MEM finding which showed lead finding.
2. 1. correct the refractive error
2. plus reading lenses for near. give single
vision or bifocal.
(based on patient's symptoms and needs.
3. if patient cannot accept plus lenses,
vision therapy can be done.
* just curious where is the NRA and PRA finding?
the diagnosis would be (1) accomodation spasm. Look at the lead MEM.(2)bilateral low compound hyperopic astigmatism.
ReplyDeletePrescribe full single vision of plus correction to be worn full time in order to aid vision and perhaps reduces the symptoms of asthenopia. The AA was improved with the correction.
TCA 1/12 after ophthalmic delivery visit. This is to assess patients' visual performance, comfort with the spectacle. If possible, we can reassess the VA, AA and CT during that visit.
after that, yearly TCA is recommended for routine eye check up.